Pneumothoraces Prevented With Use of Electromagnetic Device to Place Feeding Tubes
A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position. To systematically assess pulmonary placement and pneumothoraces i...
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Published in | American journal of critical care Vol. 29; no. 1; pp. 22 - 32 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
United States
01.01.2020
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Abstract | A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position.
To systematically assess pulmonary placement and pneumothoraces in CORTRAK-assisted feeding tube insertions.
CINAHL, MEDLINE, and Cochrane databases were searched for studies of CORTRAK-assisted feeding tube insertion. Thirty-two studies documenting pulmonary placement and/or complications of feeding tube insertion were found.
Operators recognized pulmonary placement on insertion tracings during 202 CORTRAK-assisted feeding tube insertion procedures, resulting in the immediate withdrawal of 199 feeding tubes. One pneumothorax was identified later by radiography. Seven pulmonary placements were not recognized by CORTRAK operators at the time of feeding tube insertion, resulting in 2 pneumothoraces. The incidence of pneumothorax for CORTRAK-assisted feeding tube insertions was 0.02% (3 of 17039). Of the feeding tubes inserted into the pulmonary system - either found during or after the procedure -1.4% (3 of 209) resulted in pneumothoraces (as opposed to the 19% to 28% incidence of pneumothorax for blind feeding tube insertions. Operators recognizing pulmonary placement on CORTRAK insertion tracings may have prevented 97% (202 of 209) of feeding tubes from being inserted farther into the respiratory tract.
Feeding tube insertion with an electromagnetic placement device is advantageous over blind feeding tube insertion because the operator can recognize pulmonary placement early and withdraw the feeding tube, thus decreasing the risk of pulmonary complications. |
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AbstractList | Background
A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position.
Objectives
To systematically assess pulmonary placement and pneumothoraces in CORTRAK-assisted feeding tube insertions.
Methods
CINAHL, MEDLINE, and Cochrane databases were searched for studies of CORTRAK-assisted feeding tube insertion. Thirty-two studies documenting pulmonary placement and/or complications of feeding tube insertion were found.
Results
Operators recognized pulmonary placement on insertion tracings during 202 CORTRAK-assisted feeding tube insertion procedures, resulting in the immediate withdrawal of 199 feeding tubes. One pneumothorax was identified later by radiography. Seven pulmonary placements were not recognized by CORTRAK operators at the time of feeding tube insertion, resulting in 2 pneumothoraces. The incidence of pneumothorax for CORTRAK-assisted feeding tube insertions was 0.02% (3 of 17039). Of the feeding tubes inserted into the pulmonary system – either found during or after the procedure −1.4% (3 of 209) resulted in pneumothoraces (as opposed to the 19% to 28% incidence of pneumothorax for blind feeding tube insertions. Operators recognizing pulmonary placement on CORTRAK insertion tracings may have prevented 97% (202 of 209) of feeding tubes from being inserted farther into the respiratory tract.
Conclusions
Feeding tube insertion with an electromagnetic placement device is advantageous over blind feeding tube insertion because the operator can recognize pulmonary placement early and withdraw the feeding tube, thus decreasing the risk of pulmonary complications. A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position. To systematically assess pulmonary placement and pneumothoraces in CORTRAK-assisted feeding tube insertions. CINAHL, MEDLINE, and Cochrane databases were searched for studies of CORTRAK-assisted feeding tube insertion. Thirty-two studies documenting pulmonary placement and/or complications of feeding tube insertion were found. Operators recognized pulmonary placement on insertion tracings during 202 CORTRAK-assisted feeding tube insertion procedures, resulting in the immediate withdrawal of 199 feeding tubes. One pneumothorax was identified later by radiography. Seven pulmonary placements were not recognized by CORTRAK operators at the time of feeding tube insertion, resulting in 2 pneumothoraces. The incidence of pneumothorax for CORTRAK-assisted feeding tube insertions was 0.02% (3 of 17039). Of the feeding tubes inserted into the pulmonary system - either found during or after the procedure -1.4% (3 of 209) resulted in pneumothoraces (as opposed to the 19% to 28% incidence of pneumothorax for blind feeding tube insertions. Operators recognizing pulmonary placement on CORTRAK insertion tracings may have prevented 97% (202 of 209) of feeding tubes from being inserted farther into the respiratory tract. Feeding tube insertion with an electromagnetic placement device is advantageous over blind feeding tube insertion because the operator can recognize pulmonary placement early and withdraw the feeding tube, thus decreasing the risk of pulmonary complications. BACKGROUNDA US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic placement devices that provide real-time visualization of feeding tube position. OBJECTIVESTo systematically assess pulmonary placement and pneumothoraces in CORTRAK-assisted feeding tube insertions. METHODSCINAHL, MEDLINE, and Cochrane databases were searched for studies of CORTRAK-assisted feeding tube insertion. Thirty-two studies documenting pulmonary placement and/or complications of feeding tube insertion were found. RESULTSOperators recognized pulmonary placement on insertion tracings during 202 CORTRAK-assisted feeding tube insertion procedures, resulting in the immediate withdrawal of 199 feeding tubes. One pneumothorax was identified later by radiography. Seven pulmonary placements were not recognized by CORTRAK operators at the time of feeding tube insertion, resulting in 2 pneumothoraces. The incidence of pneumothorax for CORTRAK-assisted feeding tube insertions was 0.02% (3 of 17039). Of the feeding tubes inserted into the pulmonary system - either found during or after the procedure -1.4% (3 of 209) resulted in pneumothoraces (as opposed to the 19% to 28% incidence of pneumothorax for blind feeding tube insertions. Operators recognizing pulmonary placement on CORTRAK insertion tracings may have prevented 97% (202 of 209) of feeding tubes from being inserted farther into the respiratory tract. CONCLUSIONSFeeding tube insertion with an electromagnetic placement device is advantageous over blind feeding tube insertion because the operator can recognize pulmonary placement early and withdraw the feeding tube, thus decreasing the risk of pulmonary complications. |
Author | Powers, Jan Aguirre, Lillian Bourgault, Annette M |
Author_xml | – sequence: 1 givenname: Annette M surname: Bourgault fullname: Bourgault, Annette M organization: Annette M. Bourgault is an assistant professor, University of Central Florida College of Nursing, Orlando, Florida, and a nurse scientist, Orlando Health, Orlando, Florida – sequence: 2 givenname: Jan surname: Powers fullname: Powers, Jan organization: Jan Powers is director of nursing research and professional practice, Parkview Health System, Fort Wayne, Indiana – sequence: 3 givenname: Lillian surname: Aguirre fullname: Aguirre, Lillian organization: Lillian Aguirre is clinical nurse specialist trauma/burn critical care, Orlando Regional Medical Center, Orlando Health |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31968083$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_12968_bjon_2020_29_16_978 crossref_primary_10_1002_ncp_10946 crossref_primary_10_1136_bmjgast_2021_000768 crossref_primary_10_1111_jspn_12338 crossref_primary_10_1002_ncp_10904 crossref_primary_10_3918_jsicm_29_160 crossref_primary_10_1136_tsaco_2020_000572 crossref_primary_10_4037_ajcc2023326 crossref_primary_10_1002_ncp_10671 crossref_primary_10_1016_j_iccn_2023_103492 crossref_primary_10_4037_aacnacc2022306 |
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Snippet | A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of electromagnetic... Background A US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of... BACKGROUNDA US Food and Drug Administration safety letter warned about the risk for pneumothoraces during feeding tube insertion despite the use of... |
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SubjectTerms | Electromagnetic Phenomena Humans Intubation, Gastrointestinal - instrumentation Nursing Pneumothorax - prevention & control |
Title | Pneumothoraces Prevented With Use of Electromagnetic Device to Place Feeding Tubes |
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